Methods and systems for modeling bite registration

ABSTRACT

The present invention provides methods and devices for determining an axis of upper and lower jaw articulation of a patient and modeling jaw movement about such an axis, particularly with the use of computerized visual images. The methods comprise providing digital data sets of tooth and bite configuration information which may be used to determine an estimated condylar axis of rotation for a patient. A number of data sets may be acquired and utilized for such estimations. Data sets may be obtained with the use of bite registers. Such registers may be formed by a number of methods and device designs of the present invention. The resulting digital data sets and axis of articulation may then be utilized to generate animated visual images of a patient&#39;s jaws in various bite configurations throughout a given rotation around the determined axis. Accuracy of such dynamic imaging, in addition to the determination of the location of the condylar axis, may increase with the number of bite configurations recorded throughout the rotation.

CROSS-REFERENCES TO RELATED APPLICATIONS

The present application is a continuation of U.S. patent applicationSer. No. 10/424,370 (Attorney Docket No. 018563-001620—AT-00032.2),filed Apr. 24, 2003, which is a divisional of U.S. patent applicationSer. No. 09/843,244 (Attorney Docket No. 018563-001610—AT-00032.1),filed Apr. 25, 2001, and now issued as U.S. Pat. No. 6,582,229, whichclaimed benefit of provisional Application No. 60/199,485 (AttorneyDocket No. 018563-001600—AT-00032), filed on Apr. 25, 2000, the fulldisclosures of which are incorporated herein by reference.

SUMMARY OF THE INVENTION

The present invention provides methods and devices for determining anaxis of upper and lower jaw articulation of a patient and modeling jawmovement about such an axis, particularly with the use of computerizedvisual images. The methods comprise providing digital data sets of toothand bite configuration information which may be used to determine anestimated condylar axis of rotation for a patient. A number of data setsmay be acquired and utilized for such estimations. In a preferredembodiment, data sets representing the upper jaw, lower jaw and at leasttwo bite registers may be used to determine an axis of rotation. In anadditional embodiment, data sets representing at least a first and asecond bite configuration may be used to determine such an axis ofrotation. Such bite configurations may be guided with the use of biteregisters. The above mentioned bite registers may be formed by a numberof methods and device designs of the present invention. The resultingdigital data sets and axis of articulation may then be utilized togenerate animated visual images of a patient's jaws in various biteconfigurations throughout a given rotation around the determined axis.Accuracy of such dynamic imaging, in addition to the determination ofthe location of the condylar axis, may increase with the number of biteconfigurations recorded throughout the rotation.

In a first aspect of the methods of the present invention, digital datasets representing the upper jaw of a patient, the lower jaw of thepatient and at least two bite registers may be used to determine an axisof rotation or articulation for the patient's jaws. Digital data setsrepresenting an object may be provided by scanning the object or athree-dimensional model of the object. The jaws of the patient may bemodeled by producing a plaster cast of the patient's teeth. After thetooth cast is obtained, it may be digitally scanned using a conventionallaser scanner or other range acquisition system to produce the digitaldata set. A bite register may be similarly scanned to obtain a bitedigital data set representing the register.

In a second aspect of the methods of the present invention, a biteregister may be formed by a number of methods using a variety of biteregistration devices. Bite registers may record the shape, location andorientation of the teeth of the upper jaw in relation to the teeth ofthe lower jaw when the jaws are in a given bite configuration. Ingeneral, it is only necessary to record the features and orientations ofan adequate number of teeth to determine the orientations of theremaining teeth. Thus, bite registers are typically structures having animpression of at least a surface of a tooth in the upper jaw and asurface of a tooth in the lower jaw when the upper and lower jaws are ina predetermined bite position.

In a first embodiment, a bite register may be produced by biting astructure comprised of malleable material between the occlusionalsurfaces of the posterior teeth. In this case, the structure may be ablock of such material having a predetermined thickness. When placed onboth sides of the mouth between the posterior teeth, as described, thepatient may then bite down on the blocks to record the biteconfiguration. Since the blocks are comprised of a malleable material,such as wax, polyvinyl silaxane, acrylic, plastic, plaster or any othersuitable impression material, the teeth and associated dental features,such as gingiva, will imprint in the blocks. It may be appreciated thatone continuous block may be used rather than two separate blocks, one oneach side of the mouth, or any other shape and/or number of such blocksto effectively form an impression of the occlusional surfaces.

The above described methodology of forming a bite register records abite configuration at one point in rotation of the jaws around thecondylar axis. Starting from a closed position, the lower jaw rotatesaround the condylar axis as the bite opens to a fully opened position. Abite configuration may be registered or recorded at an point in thisrotation. The point in rotation may be preselected by the thickness ofthe block prior to impression in the above described example. Thethicker the block, the more open the bite. Thus, a series of biteregisters may be formed with blocks of increasing thickness to model thebite configurations throughout the rotation or throughout a specificrange of the rotation. Such a series may be comprised of two, three,four, five, or more of such bite registers, each of which may be scannedto provide a series of bite digital data sets.

In a second embodiment, a bite register may be produced by pressing astructure comprised of malleable material against the facial surfaces ofthe anterior teeth. It has been determined that the orientations orspatial relationships of the anterior teeth of the upper and lower jawsmay adequately determine the orientations of the remaining teeth in agiven bite configuration. Such a structure may be comprised of themalleable material itself, or it may be supported by a holder. Theholder may be comprised of a plate, contoured to generally fit a dentalarch curve, and a handle. The plate may support a malleable material,such as that described previously, and may be pressed against the facialsurfaces of the anterior teeth.

Alternatively, in a third embodiment, the holder may be comprised of anupper portion and a lower portion joined by a separator to orient theupper and lower jaws in a predetermined bite position. Malleablematerial may be mounted on the upper and lower portions of the holder toform registration surfaces. An upper registration surface may contact asurface of a tooth in an upper jaw of a patient and a lower registrationsurface may contact a surface of a tooth in a lower jaw of a patient.Simultaneous contact of these registration surfaces against theappropriate teeth, by, for example, biting the registration device, mayrecord bite information correlated to the predetermined orientation ofthe registration surfaces. Such orientation may be fixed or it may beadjustable to join the upper and lower registration surfaces in a seriesof predetermined orientations. In either case, the bite information maycomprise the shape, location and orientation of at least one toothsurface in the upper jaw of a patient in relation to at least one toothsurface in the lower jaw of the patient.

Again, the above described methodology of forming a bite registerrecords a bite configuration at one point in rotation of the jaws aroundthe condylar axis. A bite configuration may be registered or recorded atany point in this rotation. The point in rotation may be preselected byopening the jaws to a desired configuration by any means. In the case ofbite registration devices comprising a separator, the registrationsurfaces may be separated and oriented to open the jaws to a desiredconfiguration based on the characteristics of the separator. Theseparator may join the upper and lower registration surfaces in a fixedpredetermined orientation, or the separator may be adjustable to jointhe registration surfaces in a series of orientations. In any case, aseries of bite registers may be formed to model the bite configurationsthroughout the rotation or throughout a specific range of the rotation.Such a series may be comprised of two, three, four, five, or more ofsuch bite registers, each of which may be scanned to provide a series ofbite digital data sets.

In a third aspect of the methods of the present invention, determinationof an axis of upper and lower jaw articulation of a patient and modelingof jaw movement about such an axis may be achieved, particularly withthe use of computerized visual images.

In a fourth aspect of the methods of the present invention, digital datasets representing a first bite configuration and a second biteconfiguration may be used to determine an axis of rotation orarticulation for the patient's jaws. This is similar to the first aspectof the methods of the present invention, described above, but utilizesdifferent data sets to determine an axis of rotation. Rather thanscanning the upper jaw, lower jaw and bite registrations separately toobtain individual representative digital data sets, the components maybe assembled in a bite configuration and scanned together. For example,a plaster cast of the lower jaw may be positioned with the teeth facingupwards. A bite register may then be placed on the cast of the lowerjaw, and a plaster cast of the upper jaw may be placed over the cast ofthe lower jaw with the teeth downwards, guided by and resting on thebite register. In this manner, the plaster casts of a patient's upperand lower dentition to be placed relative to one another in a given biteconfiguration. A cylindrical scan may then acquired for the lower andupper casts in their relative positions. The scanned data provides adigital model representing an object which is the combination of thepatient's arches positioned in a first bite configuration. This may berepeated for a second bite configuration. The second bite configurationmay be any desired bite configuration which is different from the firstbite configuration. To accomplish this, a new bite register may beobtained from the patient in the second bite configuration. Casts of theteeth may be assembled and scanned as described above.

Once digital data sets are acquired, by any method, an image can bepresented and manipulated on a suitable computer system equipped withcomputer-aided design software. The image manipulation may compriserotating an image of the lower jaw around the determined axis ofarticulation to model the movement of a patient's jaws. Such movementmay range between a closed position and a fully open position or aportion of the range therein. The computer system may be provided withrules and algorithms which move the jaw(s) in a fully automatic manner,i.e. without user intervention. Such rules and algorithms may be basedon the digital data sets representing the differing bite configurationand the determined axis of articulation.

Although a few known bite configurations may be represented, it may bedesired to interpolate intermediate bite configurations between theknown configurations to visually portray a range of jaw movement.Usually, the successive digital data sets representing theseintermediate bite configurations are produced by determining positionaldifferences between selected individual teeth in a digital data set of afirst bite configuration and digital data set of a second biteconfiguration and interpolating said differences. Such interpolation maybe performed over as many discrete stages as may be desired, usually atleast three, often at least four, more often at least ten, sometimes atleast twenty-five, and occasionally forty or more. Many times, theinterpolation will be linear interpolation for some or all of thepositional differences. Alternatively, the interpolation may benon-linear.

Often, the user will specify certain target intermediate biteconfigurations, referred to as “key frames,” which are incorporateddirectly into the intermediate digital data sets. The methods of thepresent invention then determine successive digital data sets betweenthe key frames in the manner described above, e.g. by linear ornon-linear interpolation between the key frames. The key frames may bedetermined by a user, e.g. the individual manipulating a visual image atthe computer used for generating the digital data sets.

BRIEF DESCRIPTION OF THE DRAWINGS

FIGS. 1A-1C show various bite configurations of a patient illustratingthe orientations of the upper and lower jaws in rotation about thecondylar axis.

FIG. 2 is a side view of a the upper and lower jaws of a patientregistering a bite in a block of malleable material placed between theocclusional surfaces of the posterior teeth.

FIG. 3 is a perspective view of a bite register resulting from theformation illustrated in FIG. 2.

FIG. 4 is a illustration of a bite registration device.

FIG. 5 illustrates a bite registration device, as shown in FIG. 4, inuse to form a bite register.

FIG. 6 illustrates a bite register formed by a method as shown in FIG.5.

FIG. 7 is a perspective view of a bite registration device having anadjustable separation between bite registration surfaces.

FIG. 8 illustrates a bite registration device, as shown in FIG. 7, inuse to form a bite register.

FIG. 9 is a perspective view of a bite registration device having afixed separation between bite registration surfaces.

DESCRIPTION OF THE SPECIFIC EMBODIMENTS

Bite configurations may be recorded with the use of a bite register. Abite register is a device which records the shape, location, andorientation of the teeth of the upper jaw in relation to the teeth ofthe lower jaw when the jaws are in a given bite configuration. Theserelationships may then be used to recreate the bite configuration withmechanical models or computerized images of the teeth. If a series ofbite configurations are recorded, for example from a closed biteconfiguration to a fully open bite configuration, the full rotation ofthe condylar axis may be modeled for a given patient. Accuracy of thedynamic modeling, in addition to the determination of the location ofthe condylar axis, may increase with the number of bite configurationsrecorded throughout the rotation.

A number of methodologies may be used to record bite configurations toform a bite register. In general, bite registers record the features andorientations of an adequate number of teeth to determine theorientations of the remaining teeth. This is typically achieved byforming impressions of the teeth of both the upper and lower jaws whenthe jaws are in a biting configuration. Referring to FIG. 2, this may beachieved by placing a block 200 of malleable material between theocclusional surfaces of the upper and lower posterior teeth 202, 204 ofa patient as shown. Typically, two such blocks 200 may be used, oneplaced on the right side of the mouth and one in the same or similarposition on the left side. Thus, when the patient bites down on theblocks 200, the bite configuration on both sides of the mouth may berecorded simultaneously. Since the block 200 is comprised of a malleablematerial, such as wax, polyvinyl silaxane, acrylic, plastic, plaster orany suitable impression material, the teeth 202, 204 will imprint orform depressions in the block 200 corresponding to the shapes, locationsand orientations of the teeth 202, 204. The result, as shown in FIG. 3,is a bite register 206. Here, impressions 208 of the surfaces of theteeth and associated dental features, such as gingiva, in the top jawmay be seen in the top surface 210 of the block 200. Similarly,impressions 212 of the surfaces of the teeth and associated dentalfeatures in the bottom jaw may be made in the bottom surface 214 of theblock 200, represented by dashed lines. Thus, spatial relationshipsbetween the upper jaw and the lower jaw may be recorded.

The above described methodology of forming a bite register records abite configuration at one point in rotation of the jaws around thecondylar axis. Starting from a closed position, the lower jaw rotatesaround the condylar axis as the bite opens to a fully opened position. Abite configuration may be registered or recorded at any point in thisrotation. The point in rotation may be preselected by the thickness ofthe block prior to impression in the above described example. Thethicker the block, the more open the bite. Thus, a series of biteregisters may be formed with blocks of increasing thickness to model thebite configurations throughout the rotation or throughout a specificrange of the rotation.

In a preferred embodiment of a method of the present invention, a biteregister may be comprised of an impression of the facial surfaces of theanterior teeth. It has been determined that the orientations or spatialrelationships of the anterior teeth of the upper and lower jaws mayadequately determine the orientations of the remaining teeth in a givenbite configuration. In particular, the spatial relationships between thefacial surfaces of the incisors may be adequate to model a biteconfiguration. Using these surfaces to form a bite register provide anumber of advantages: 1) the facial surfaces of the anterior teeth areeasily accessible for impression formation since the surfaces lieagainst the lips, 2) the surfaces required for adequate modeling of thebite configuration may be relatively low, typically requiring only theanterior surfaces of the incisors, possibly only requiring one surfaceon the top jaw and a correlating surface on the bottom jaw, and 3)variability in the point in the condylar axis rotation chosen for agiven bite configuration may be reduced since the jaws may be opened toa given point in the rotation by non-malleable supports. In thepreviously described method, the jaws were set to a given point in therotation by the thickness of a block of malleable material placedbetween the jaws. However, the act of biting the blocks may compress theblocks to an undetermined thickness, increasing the variation in actualaxis rotation. In the above described embodiment of a method of thepresent invention, the jaws may be set to a given point in the rotationby any means, such as shim stock or non-malleable supports placedbetween the jaws. The bite may then be registered by forming animpression of the facial surfaces of the anterior teeth as described.

Referring to FIG. 4, such an impression may be made with the use of aholder 220. Such a holder 220 may be comprised of a plate 222, contouredto generally fit a dental arch curve, and a handle 224. The plate 222may support a malleable material 226, such as wax, polyvinyl silaxane,acrylic, plastic, plaster or any suitable impression material, intowhich an impression may be made. As shown in FIG. 5, the material (notshown) and holder 220 may be pressed against the facial surfaces of theanterior teeth 228. In this manner, the material 226 may contact thefacial tooth surfaces and press through any space between the teeth ofthe upper and lower jaws. Thus, the material may also contact someocclusional and lingual surfaces of the teeth 228. This is particularlythe case when the bite is at least partially open. The resulting biteregistration may appear as in FIG. 6. Here, a cross-section of thematerial 226, plate 222 and handle 224 are shown to illustrate typicalcontours of the impression in the malleable material 226. An upperdepression 230 may reflect the surfaces of an incisor in the upper jawand a lower depression 232 may reflect the surfaces of an incisor in thelower jaw. A protrusion 234 may be formed between these depressions 230,232 due to the material 226 pressing between the jaws. Similarimpressions or depressions from the surfaces of the surrounding teethmay be seen in perspective view in FIG. 6.

It may be appreciated that the curvature of the plate may serve toprovide improved contact of the malleable material with the facial toothsurfaces. However, the plate may have any contour to achieve desiredresults. Also, the malleable material may be used without the holder orsimilar device. In such a case, the material itself may simply bepressed against the teeth.

Referring to FIG. 7, a preferred embodiment of a bite registrationdevice 250 to form an impression of the facial surfaces of the anteriorteeth is depicted. Such a device 250 may be comprised of an upperregistration surface 252, a lower registration surface 254 and aseparator 255 joining the upper and lower registration surfaces 252,254. In this example, each registration surface is comprised ofmalleable material 255 supported by a holder 256. The holders 256 areattached to the separator 255 which holds the registration surfaces 252,254 apart at a desired distance 258. In this example, the separator 255is adjustable so that the distance 258 between the registration surfaces252, 254 may be set to a desired amount of separation. It may also bepossible for the separator 255 to adjust the orientation of theregistration surfaces 252, 254, such as varying the tilt of the surfacesand/or the spatial relationship between the two surfaces. To form a biteregister, as illustrated in FIG. 8, a patient may bite the biteregistration device 250 so that a surface of a tooth in the upper jaw260 contacts the upper registration surface 252 and a surface of a toothin the lower jaw 262 contacts the lower registration surface 254. Suchcontact forms an impression of the tooth surfaces 260, 262 in theregistration surfaces 252, 254, thus recording the bite configuration.When biting the registration device 250, the predetermined orientationsof the registration surfaces 252, 254 may set the jaws to a given pointin rotation about the condylar axis. Thus, the further apart theregistration surfaces 252, 254 are set, the more open the biteconfiguration becomes. This may ensure the recording of a biteconfiguration at a specific point in rotation about the condylar axis,and it may reduce variability in such recording. To record biteconfigurations throughout a portion of the range of rotation, a numberof bite registers may be made with the registration surfaces atdiffering separation distances.

This may easily be achieved with an adjustable registration device, asdescribed above. However, this may also be achieved with the use of anumber of registration devices, each with a fixed separation distance.Such a device embodiment is depicted in FIG. 9. Here, the registrationsurfaces 252, 254 are comprised of a malleable material 255 supported bya separator 270, which is attached to a handle 272. The separator 270may be a solid structure which holds the material 255 apart at a desireddistance 258. The structure may also provide a desired orientation ofthe registration surfaces 252, 254, providing a specific tilt of thesurfaces and/or a spatial relationship between the two surfaces. To forma bite register, a patient may bite the bite registration device 268 sothat a surface of a tooth in the upper jaw 260 contacts the upperregistration surface 252 and a surface of a tooth in the lower jaw 262contacts the lower registration surface 254, as previously depicted inFIG. 8. Again, such contact forms an impression of the tooth surfaces260, 262 in the registration surfaces 252, 254, thus recording the biteconfiguration. When biting the registration device 268, thepredetermined orientations of the registration surfaces 252, 254 may setthe jaws to a given point in rotation about the condylar axis. To recordbite configurations throughout a portion of the range of rotation, anumber of bite registers may be made with the registration surfaces atdiffering separation distances.

Bite registers obtained from any method may be used to recreate the biteconfiguration of a patient with mechanical models or computerized imagesof the teeth. As previously mentioned, a series of bite registers may beused to model the bite configurations throughout a range of rotationabout the condylar axis. A series of such models may then be used todetermine the location of the condylar axis.

The present invention provides a method for determining an axis of upperand lower jaw articulation. A preferred embodiment of a method of thepresent invention utilizes an upper digital data set, representing theupper jaw of the patient, a lower digital data set, representing thelower jaw of the patient, and at least two bite digital data sets, eachrepresenting a bite register. However, three or more digital data setsmay also be used.

Digital data sets of information to model an object, such as a patient'supper jaw, a patient's lower jaw or a bite register, may be obtained ina variety of ways. For example, the object may be scanned or imagedusing well known technology, such as X-rays, three-dimensional X-rays,computer-aided tomographic images or data sets, magnetic resonanceimages, etc. Methods for digitizing such conventional images to producedata sets useful in the present invention are well known and describedin the patent and medical literature. However, digital data sets of apatient's teeth will typically rely on first obtaining a plaster cast ofthe patient's teeth by well known techniques, such as those described inGraber, Orthodontics: Principle and Practice, Second Edition, Saunders,Philadelphia, 1969, pp. 401-415. After the tooth casting is obtained, itcan be digitally scanned using a conventional laser scanner or otherrange acquisition system to produce the digital data set. The data setproduced by the range acquisition system may, of course, be converted toother formats to be compatible with other software. General techniquesfor producing plaster casts of teeth and generating digital models usinglaser scanning techniques are described, for example, in U.S. Pat. No.5,605,459, the full disclosure of which is incorporated herein byreference.

There are a variety of range acquisition systems, generally categorizedby whether the process of acquisition requires contact with the threedimensional object. A contact-type range acquisition system utilizes aprobe, having multiple degrees of translational and/or rotationalfreedom. By recording the physical displacement of the probe as it isdrawn across the sample surface, a computer-readable representation ofthe sample object is made. A non-contact-type range acquisition devicecan be either a reflective-type or transmissive-type system. There are avariety of reflective systems in use. Some of these reflective systemsutilize non-optical incident energy sources such as microwave radar orsonar. Others utilize optical energy. Those non-contact-type systemsworking by reflected optical energy further contain specialinstrumentation configured to permit certain measuring techniques to beperformed (e.g., imaging radar, triangulation and interferometry).

A preferred range acquisition system is an optical, reflective,non-contact-type scanner. Non-contact-type scanners are preferredbecause they are inherently nondestructive (i.e., do not damage thesample object), are generally characterized by a higher captureresolution and scan a sample in a relatively short period of time. Onesuch scanner is the Cyberware Model 15 manufactured by Cyberware, Inc.,Monterey, Calif.

The methods of the present invention will rely on manipulating the datasets at a computer or workstation having a suitable graphical userinterface (GUI) and software appropriate for viewing and modifying thegenerated images. Specific aspects of the software will be described indetail hereinafter.

According to the methods of the present invention, the axis of upper andlower jaw articulation may also be determined by manipulating data setsof bite configurations. A preferred embodiment of such a method will bedescribed. To begin, a bite register is obtained from a patient in afirst bite configuration. This may be any desired bite configurationranging from closed to fully open. The bite register enables mechanicaltooth/jaw models, such as plaster casts, to be positioned in arepresentative bite configuration for scanning. This is usuallyaccomplished by first placing the lower cast in front of the scanner,with the teeth facing upwards, then placing the bite register on top ofthe lower cast, and finally by placing the upper cast on top of thelower cast, with the teeth downwards, resting on the bite register. Acylindrical scan is then acquired for the lower and upper casts in theirrelative positions. The scanned data provides a digital model of mediumresolution representing an object which is the combination of thepatient's arches positioned in the first bite configuration. This may berepeated for a second bite configuration. The second bite configurationmay be any desired bite configuration which is different from the firstbite configuration. To accomplish this, a new bite register may beobtained from the patient in the second bite configuration. Casts of theteeth may be assembled and scanned as described above.

1. A method for digitally modeling a bite configuration of a patient,the method comprising: acquiring a first digital scan of at least someof a patient's upper and lower teeth while the patient is biting aregistration device oriented at a first separation distance; acquiringat least a second digital scan of at least some of the patient's upperand lower teeth while the patient is biting a registration deviceoriented at a second separation distance; generating at least first andsecond bite digital data sets from the first and second digital scans;and locating a condylar axis of the patient, based on at least the firstand second digital scans and the first and second bite digital datasets.
 2. A method as in claim 1, further comprising: acquiring a thirddigital scan of at least some of the patient's teeth while the patientis biting a registration device oriented at a third separation distance;and generating a third bite digital data set from the third digitalscan, wherein locating the condylar axis is based on at least the first,second and third digital scans and the first, second and third bitedigital data sets.
 3. A method as in claim 1, wherein acquiring thedigital scans comprises acquiring at least one of a digitized X-ray, acomputed tomography scan and a magnetic resonance imaging scan.
 4. Amethod as in claim 1, wherein the digital scans are acquired while thepatient is biting a registration device that contacts only anteriorteeth of the patient.
 5. A method as in claim 1, wherein the digitalscans are acquired while the patient is biting a registration devicethat contacts only posterior teeth of the patient.
 6. A method as inclaim 1, further comprising providing at least one image showing thepatient's bite configuration.
 7. A method as in claim 6, furthercomprising providing a series of images showing articulation of a lowerjaw of the patient about the condylar axis.
 8. A method as in claim 7,wherein the series of images is generated automatically via a computeralgorithm.
 9. A method as in claim 6, further comprising manipulatingthe at least one image to show an alternative bite configuration for thepatient.